PCA - North Water Treatment Plant Improvements Proj No. 119-011 - Bowen Engineering Corp.

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BOWEN Engineering Corporation WAIVER OF LIEN { } Final {X} Partial {X} Payment to Follow State of Indiana, County of ___Newton______________________________________________, SS: _____Patrick Stanford_______________________________ being duly sworn states that he/she is the __Project Manager___________________ (Name of Officer) (Title) of__ Bowen Engineering Corporation__ having contracted with _City of South Bend, IN ___ (Contractor) (Owner) to furnish certain materials and/or labor as follows: ___Supervision, Labor, Equipment and Material________________________________ (Description) for a project known as __North WTP Improvements located at _830 North Michigan Street, South Bend, IN 46601 and owned by City of South Bend, IN ___ (Owner) and does hereby further state on the behalf of the aforementioned Contractor: (PARTIAL WAIVER) that there is due from the Owner the sum of ($ ) { } receipt of which is hereby acknowledged; or { } the payment of which has been promised as the sole consideration for this Affidavit and Partial Waiver of Lien which is given solely with respect to said amount, and which waiver shall be effective only upon receipt of payment thereof by the undersigned. (FINAL WAIVER) that the final balance due from the contractor is the sum of TEN THOUSAND DOLLARS ($10,000.00) { } receipt of which is hereby acknowledged; or {X} the payment of which has been promised as the sole consideration for this Affidavit and Final Waiver of Lien which shall become effective only upon receipt of such payment. THEREFORE, the undersigned waives and releases unto the Owner of said premises, any and all lien or claim whatsoever on the above-described property and improvements thereon on account of LABOR or material or both, furnished by the undersigned thereto, subject to limitations or conditions expressed herein, if any; and further certifies that no other party has any cla im or right to a lien on account of any work performed or material furnished to the undersigned for said project, and within the scope of this affidavit and waiver. ___Bowen Engineering Corporation___ By ____ _______________________________________ (Firm) (Patrick Stanford, Project Manager) WITNESS MY HAND AND NOTORIAL SEAL, this ____20TH ____________ day of __May 20_24_______. __________________________________________________________ (Notary Public) My Commission Expires_____June 5, 2032_____ Printed _______Margaret Burroughs____________________________________ Residing in ____Newton________________________ County 10769 Broadway, #325, Crown Point, IN 46307 219-661-9770 Fax: 219-661-9766